Key to icons

Results for 'intervention'

Loneliness and isolation are not the same. The causes of loneliness are not just physical isolation and lack of companionship, but also sometimes the lack of a useful role in society. Estimates of prevalence of loneliness tend to concentrate on the older population and they vary widely, with reputable research coming up with figures of 6%-13% of the UK population being described as often or always lonely. This evidence review has been produced in order to provide evidence to underpin decision-making for people involved in commissioning, service development, fundraising and influencing. It discusses: the policy context; what is known about loneliness and isolation in older people; and what has been done (including one-to-one services, group services, and community involvement) and how effective they were. The key messages from the evidence are listed.

Loneliness is a significant and growing issue for many older people. Research over decades has found that acute loneliness has been consistently estimated to affect around 10-13% of the population of older people. Over the same time period, there has been a growing percentage of older people who sometimes feel lonely. Loneliness makes older people vulnerable to developing chronic health problems, depression and increases the need for social care services or residential care. This guide offers a brief summary of key research on the issue of loneliness, and some practical steps every local authority, working in partnership with other statutory bodies and their partners, can take to tackle loneliness, setting them in the context of an overall framework for action. The described framework comprises 3 tiers of actions: at the strategic level across the local authority; at the level of the community; and at the level of the individual. Suggested practical steps are illustrated by case studies drawn from around the country.

Loneliness occurs at all stages of life but little attention has been paid to its incidence and impact in the oldest old (85+), the fourth generation. This report begins by exploring: loneliness and why it matters; the incidence of loneliness in older people; and what is known about loneliness in the oldest old (85+). It then looks six contextual criteria that should be considered when initiating or commissioning interventions to tackle loneliness: rural and urban living; gender; health; living alone; community resilience; intergenerational interaction and ageism. Using case study analysis of projects that are tackling loneliness effectively, the report then explores practical steps that can be taken to reduce levels of loneliness among the oldest old. The case studies include one-to-one interventions, group services and building social networks; and encouraging wider community engagement. The case studies also illustrate the continued willingness of individuals of all ages to get involved in their local community. Whereas people might once have volunteered informally to help people they knew, ‘permission’ to initiate contact, through formalised and structured opportunities, is important. This is an important pointer as to how our modern society can organise itself to help address loneliness.

This study provides economic evidence to support the case for investing in effective, recovery-focused services for people with schizophrenia and psychosis. Drawing on a wide range of data, it sets out the evidence for the cost-effectiveness for a range of interventions and service. Those discussed are: Early Detection (ED) services; Early Intervention (EI) teams; Individual Placement and Support (IPS); Family therapy; Criminal justice liaison and diversion; Physical health promotion, including health behaviours; Supported housing; Crisis Resolution and Home Treatment (CRHT) teams; Crisis houses; Peer support; Self-management; Cognitive Behavioural Therapy (CBT); Anti-stigma and discrimination campaigns; Personal Budgets (PBs); and Welfare advice. For each intervention the report provides information on the context, the nature of the intervention, the evidence on effectiveness and cost-effectiveness, and the policy and practice implications. The report finds evidence to suggest that all of the interventions contribute to recovery outcomes, reduced costs and/or better value for money. Examples of the savings incurred through particular interventions are also included. The study was undertaken by a team from the Personal Social Services Research Unit (PSSRU), at the London School of Economics and Political Science (LSE), the Centre for Mental Health, and the Centre for the Economics of Mental and Physical Health (CEMPH) at King’s College London.

Over the last five years the Nuffield Trust has undertaken evaluations of over 30 different community-based interventions. In many cases the authors have been tasked with identifying whether service changes have led to a reduction in emergency admissions and the associated cost to the NHS. Using these indicators, the results have been almost overwhelmingly negative. The one exception was Marie Curie Nursing Services for terminally ill patients. In this paper the authors outline the main community-based interventions they have evaluated and their impact, and identify nine points that may help those designing, implementing and evaluating such interventions in future. The paper could provide useful learning for the new health and social care integration ‘pioneer’ sites that will be appointed by the Department of Health by September 2013.

This guide aims to give an overview of the range, diversity and positive impact of mentoring and befriending activity. Using case studies and programme examples, it outlines a range of mentoring and befriending approaches and identifies the key potential outcomes, including reduced offending, improved community cohesion, improved access to employment, reduced social isolation, higher aspirations and increased independence. The document also explains how the Mentoring and Befriending Foundation can support commissioners identify effective programmes.

With ageing populations, social changes and rising public expectations, many countries are exploring ways of developing a more preventative approach within their health and social care services. In England, this has become a growing priority over time—made even more significant by recent economic change and by the urgent need to reduce public sector spending. However, a key dilemma for policy makers and managers is the patchy nature of the evidence base—with a lack of certainty over how to reform services or prioritise spending in order to develop a more genuinely preventative approach. Against this background, this commentary reviews national and international evidence around ten policy measures and interventions, highlighting some of the most promising approaches as well as the fragmented and contested nature of the evidence base.

This paper shares outcomes from the evaluation of a community project where comedy activities were introduced into a day centre for older people with dementia as a result of a partnership between the day centre, a local university and a specialist comedy provider. Four workshops were provided using improvisatory activities and comedy, as a medium to engage older people in reflecting on aspects of their care environment. The main output resulted in a 30 minute ‘mockumentary’ of the ‘Her Majesty the Queen’ visiting the day centre, in the form of a digital reusable learning object to be used by social work and mental health professionals. The evaluation demonstrated some additional outcomes for those involved and highlighted the benefits of laughter and fun in promoting a positive climate.

NATIONAL INSTITUTE FOR HEALTH RESEARCH. School for Social Care Research
2013

A scoping study investigated approaches to prevention services in local authorities which enable older people to retain their independence for as long as possible to maintain their quality of life and reduce pressure on local authority and NHS budgets. The study involved a survey of Directors of Adult Social Services in 9 local authorities to identify what they viewed as their top 3 investments in prevention services for older people, and interviews with lead managers for each intervention. It also reviewed local and national evidence as to whether these interventions lead to a delay or reduction in uptake of social care services This paper summarises the key findings from the research. It explains that the top 3 interventions were reablement (a top 3 approach for all of the local authorities surveyed), technology-based interventions (among the top 3 interventions in 6 authorities), and information and advice (among the top 3 in 3 authorities), while a number of other prevention interventions were identified by one local authority each. It reports on how local authorities seek evidence and guidance on prevention services and factors influencing how local funding was spent, and on assessment of the outcomes and impact of prevention interventions. It also summarises national and local evidence for the top 3 interventions.

Purpose: The purpose of this paper is to summarise two 2014 research papers that highlight the role of social interactions and the social world in recovery in the context of mental distress.
Design/methodology/approach: The author summarise two papers: one is about two theories from social psychology that help us understand social identity – our sense of who we are. The other brings together and looks at the similarities and differences between ten different therapies that can be called resource-oriented – that is, they focus on people's strengths and resources rather than what is wrong with them.
Findings: The paper on social identity gives a convincing case for incorporating teaching about social identity – and the social groups to which people belong – into the training of mental health professionals. The paper on resource-oriented therapies suggests that social relationships are a main component of all ten therapies examined. This second paper suggested a need for more research and theory relating to resource-oriented therapies. Social identity theory could help address this issue. Mental health services may be able to help people more by focusing on their established and desired social identities and group-belonging, and their strengths, than is usual.
Originality/value: These two papers seem timely given the growing recognition of the role of social factors in the development and maintenance of mental distress. More attention to social factors in recovery could help make it more self-sustaining.